Acne

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Nearly everyone experiences oily skin and spots at some point in their life – but for some people, normal teenage spots can develop into chronic acne.

What is acne?

Acne is a common skin condition usually arising in adolescence. It causes blackheads, spots and cysts to develop on the face, and often on the back, shoulders and chest. Skin affected by acne is oily, and often red, inflamed and painful.

Acne varies in severity. Some people only get oily skin and spots on their face, and find that it clears up once they are in their late teens. Other people develop large pustules and cysts across their face, back and chest, and are left with scarring. Some people don’t develop acne until adulthood – this is more common in women.

Not all cases of acne require medical attention or prescription treatment, but if you’re concerned you should speak to a doctor.

What are the symptoms of acne?

The characteristic symptoms of acne are oily skin and spots, however the precise symptoms vary from person to person.

The NHS describes six varieties of spot commonly experienced by people with acne:

  • Blackheads – small black dots
  • Whiteheads – small raised spots
  • Papules – small bumps that are painful, inflamed and red in colour
  • Pustules – similar to papules but with a white centre caused by pus build-up
  • Nodules – large raised bumps under the skin that are often painful
  • Cysts – large, painful pus-filled lumps

The more severe your acne, the more painful and tender it will feel. Nodules and cysts are particularly prone to bursting, which can cause bleeding and lead to permanent scarring.

What causes acne?

We get spots when the hair follicles in our skin become blocked with dead skin and sebum (an oily substance that lubricates the skin and hair). In people with acne, glands in the skin produce too much sebum, which means the follicles are always becoming plugged.

If bacteria on the skin infect these plugged follicles they can become inflamed, developing into painful papules, pustules, nodules and cysts.

Acne is associated with hormone levels. At puberty, the body produces more testosterone (in both boys and girls), which is thought to affect the sebaceous glands.

It’s also believed that female hormones can have an impact on the production of sebum, which is why adult acne is more common amongst women. If you’re a woman who suffers from acne, you might notice that you get flare-ups around the time of your period or during the early months of pregnancy.

How is acne diagnosed and treated?

If you’re concerned about your spots you should speak to a doctor. They will look at the affected skin on your face, back, shoulders and chest to decide how severe your condition is.

If you have moderate or severe acne – which is characterised by having lots of papules and pustules, as well as nodules and cysts – you will probably require prescription treatment, and possibly a referral to a dermatologist.

If you only have mild acne – mostly whiteheads and blackheads with a few papules and pustules – you should be able to manage your spots at home with over-the-counter treatments containing benzoyl peroxide.

Prescription treatments for acne include:

  • Topical retinoids
  • Topical antibiotics
  • Antibiotic tablets
  • Azelaic acid
  • Isotretinoin tablets
  • For women, the combined contraceptive pill

Usually people with severe acne are prescribed a combination of antibiotic tablets and topical treatments (i.e. gels or creams to apply directly to the skin).

You can book a consultation with Doctor Care Anywhere to receive advice on your acne. If appropriate, our doctors can prescribe acne treatment.

How can I avoid getting acne?

It’s not always easy to avoid acne, but there are some things you can do to manage the condition and prevent it from getting worse or causing scarring.

  • Avoid irritation – Wash the affected area with mild soaps or cleansers and lukewarm water, no more than twice a day. Shower after exercising to prevent sweat irritating the skin.
  • Resist the urge to squeeze – Squeezing spots can make them worse and cause permanent scarring.
  • Remove make-up – Take off make-up before going to bed, and try to use non-comedogenic products (these do not block the skin as much as other products).
  • Use over-the-counter treatments – Speak to a pharmacist about your options and make sure you use products as directed.

Content reviewed by Jemma Shafier, a Doctor Care Anywhere GP